♥Update on Paul♥ Friday 6 pm Cora at Paul Tonkos office faxed me a release to sign which I faxed back today. I am also writing to our Senator Cecelia Tkacayk with all pertinent info to try to get her intervention in the Blue Cross denial decision. thank you all for your help and support in getting word out on what these insurance companies are doing to people. Our insurance pays for unlimited rehab, thus the reason for finding any excuse possible to deny rehab for Paul. They want me to file for medicaid for Paul and put him in a nursing home to rot and have the government and state pay for it. The Blue Cross Caseworker also told me she could not guarantee they would pay for Paul for the next 7 day review for his stay here at Memorial. I told her it was because of Blue Cross we were still here and she said, I know.. Really?? These insurance companies walk all over you and have not even allowed me to appeal anything as Pauls advocate. Faxed them all the paperwork they asked for Wednesday and they told me they would call me back with how to proceed. Never called me back. When I called Pauls Blue Cross caseworker to see why they denied Pathways, she said it was based on Pauls hospitalist, Dr Kirkwood here who had a conversation with the medical director at BC Medical Management Office yesterday, who told them that Paul was total care and not a candidate for acute rehab. When I confronted Dr. Kirkwood today and told him Paul had been denied placement because of what he said to them, he said that was not true and he never got a chance to say anything. They called him and he called back and he was told by the Medical Director at Blue Cross that Paul was denied and not eligible for acute rehab, He said when they called him they had already made up their mind what they were going to do and nothing he said would have changed Blue Cross decision. So i am being lied to by someone. Dr Kirkwood knows nothing about Paul and has only seen Paul 4 times and checked his heart and left. Paul was always asleep when he came in and he never did a neuro check on him or tried to wake him up. When he came in today, Paul was wide awake and he commented it was the first time he ever saw him with his eyes open. I told him Paul has his days and nights mixed up and is usually awake all night and sleeps and off during the day. I said you never once tried to wake him up. He went over to Paul and asked him to squeeze his hand which Paul did. He was very surprised and said, oh he did it. I said yes, and he wiggles his toes too. Dr, Kirkwood told me he would recommend Paul be evaluated by the Intensive Rehabilitation Department here at the hospital and that he wanted the best for Paul. He was not qualified to make any decisions to begin with regarding Paul and his stroke and what type of rehabilitation he needed or did not need. I cant understand why Blue Cross did not follow up with Pauls stroke doctors here who treated him or neurologists who treated him is beyond me. I was told by Pauls stroke Dr. that the type of stroke Paul suffered was the most recoverable type of stroke a person could have depending upon them waking up which Paul has done. It is all about the money and BC does not want to pay for the unlimited rehab that is in his contract and is looking for any way out that they can find. Paul would never be in the position he is in if he had received proper medical care for his high blood pressure. This is the price he is paying for sloppy medical care and now they want to put him in a nursing home to forget about him and let him waste away. Over my dead body will that ever happen. I will fight to the death for the justice Paul deserves and he will get the top notch medical attention he deserves. The Social Worker came in at 4:00 today and said Dr. Kirkwood wrote a note that Paul was eligible for rehabilitation based on todays exam and Social workers received a call from Blue Cross that they were reviewing Pauls case. We will see what happens now.
Posted on: Fri, 28 Mar 2014 23:42:19 +0000
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